Federal Work-Study Request Form - Yuba Community College District

Yuba Community College District

Financial Aid Offices

Woodland Community College

Lake County Campus

2300 East Gibson Road

15880 Dam Road Extension

Woodland, CA 95776

Clearlake, CA 95422

530-661-5725

707-995-7923

2017/2018 FEDERAL WORK-STUDY REQUEST FORM

If you are interested in beginning a FWS job. If eligible, and if there are funds available in the program, we may offer

you an FWS award. Keep in mind that job placement depends on your skills, and in some cases, your availability to

work certain hours. An offer of FWS does not guarantee you a job. Fill out this form to your best ability and return

this form to the Financial Aid Office.

Note: Incomplete forms will not be reviewed. If you are offered FWS, we will communicate next steps to you via

email.

STUDENT INFORMATION

______________________________________________

__________________________

First

Last

Student ID#

______________________________________________

__________________________

Mailing Address

Home Phone/Cell Phone

______________________________________________

__________________________

City

State

Zip Code

Date of Birth

REQUEST INFORMATION

If you are requesting FWS to return to a previous FWS job or have been offered a FWS job, provide the following:

______________________________________________

____________________________________

Employer

Department

______________________________________________

____________________________________

Supervisor’s Name

Supervisor’s Phone #

STUDENT CERTIFICATION

I understand that even if I did not indicate interest in FWS employment on my FAFSA, by completing this form, I am

indicating interest in a FWS job. Further, I understand that all of the information above must be complete in order to

be considered for FWS. I also understand that this is a REQUEST, therefore, it may be denied. If I am awarded, other

aid may be cancelled or reduced to allow for awarding FWS.

Student Signature: _____________________________________

Date: _______________________

FOR FINANCIAL AID OFFICE USE ONLY:

 Yes

 No

 Don’t Know

SAR Date: _____________________________

FWS Question:

Approved

 Denied

SAP Status: ____________________________

Appeal Filed:

Unmet Need: ___________________________

Enrollment Status: __________________________

 Eligible for FWS

 Not Eligible for FWS

________________________

___________

FA Tech

Date

Federal Work-Study Request Form - Yuba Community College District - 2017/2018

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